Inland Imaging, the Spokane areas largest provider of radiology services, has taken initial steps to enter the fast-growing Phoenix market, and is considering expanding into also-hot Las Vegas, says top executive Steve Duvoisin.


In Phoenix, it has hired a radiologist and formed two companies, Desert Imaging Associates PS and Desert Imaging LLC, through which it plans to offer services and to operate imaging centers jointly with an undisclosed hospital system, Duvoisin says.


Inland Imaging hopes to have a contract in place with that hospital system within the next few months and to open its first imaging center there, on a new hospital campus, within about 18 months, he says. He envisions that it will develop four or five imaging centers in the Phoenix area in the coming years, and says the hospital system that Inland Imaging is working with plans to build four new hospitals in the Phoenix area over the next six years.


As far as starting up, in Phoenix were probably 70 percent there. In Las Vegas, were probably 5 percent there, he says.


Separately, Inland Imaging is looking to expand its presence in the Seattle area, where it operates one outpatient imaging center and provides radiology services to two multispecialty clinics. Duvoisin declines to elaborate on those plans, except to say that Inland Imaging intends to partner with unnamed health-care providers there and expects some of that expansion to occur over the next 12 to 18 months.


The key in all this growth is that we keep our focus on Spokane, what were doing here, because this is where the company continues to generate by far the biggest share of its revenue, he says.


Inland Imaging had record revenues of between $50 million and $60 million last year, and currently is growing at a rate of about 5 percent annually. Duvoisin says its billings have been rising at a much faster rate, but its collections have been impeded by a continuing deterioration in insurance reimbursement rates.


The Inland Imaging enterprise includes four entities that collectively employ more than 500 people. They are Inland Imaging LLC, Inland Imaging Associates PS, Inland Imaging Management Inc., and Duvoisin & Associates LLC.


Inland Imaging LLC employs about 300 people and operates four outpatient imaging centers in the Spokane area and the one in Seattle. Its largest imaging center, a recently expanded facility at Holy Family Hospital, now is seeing about 500 patients a day.


Inland Imaging Associates is the medical practice, which includes 52 radiologists and five vascular surgeons. It provides services not only through the imaging centers here, but also to 12 rural hospitals across the Inland Northwest and to the Seattle clinics.


It currently is interpreting more than 600,000 patient studies a year. Those studies are collections of internal body images gathered using technologies such as computed tomography, magnetic-resonance imaging (MRI), ultrasound, nuclear medicine, and fluoroscopy.


Inland Imaging Management, an umbrella entity owned by some of the radiologists, owns Inland Imaging LLC jointly with Sacred Heart Medical Center and Holy Family Hospital. It also owns the Inland Imaging centers at 525 S. Cowley and at 12420 E. Mission in Spokane Valley, as well as Duvoisin & Associates.


Duvoisin & Associates is the managing company for Inland Imaging LLC and Inland Imaging Management. It handles business functions such as billing, accounting, operations management, information systems, and strategic planning, and employs about 150 people.


It occupies the entire 18,000-square-foot third floor of the Riverpoint One Building, at 501 N. Riverpoint Blvd., but will move July 1 into two buildings at 801 S. Stevens that have a total of about 30,000 square feet of office space and formerly housed the headquarters of Itronix Corp. Inland Imaging Management disclosed last month that it had agreed to buy those buildings for about $3.3 million.


Duvoisin & Associates will provide some management services for the Phoenix operations, which likely will mean hiring more employees here over time, and the space on Stevens is large enough to handle that growth, he says.


Duvoisin is CEO of all four business entities here, but says a separate CEO likely will be hired to oversee the two newly formed Desert Imaging companies.


Despite Phoenixs large and rapidly expanding populationit now is the sixth largest city in the U.S.radiology services are fragmented there, Duvoisin says. He says he sees lots of opportunity there for a radiology-services enterprise that uses a partnership-based business model like the one Inland Imaging has developed.


I think that model has worked well in Spokane, he says.


Along with the hospital system being a joint owner of the imaging centers opened there, radiologists who join Desert Imaging Associates will have an opportunity to become part-owners in Inland Imaging Management, Duvoisin says.


He says hes struck by how much Inland Imaging has grown since he came aboard in 1984, when it had just six radiologists and 25 employees overall. Similarly, he says, when Duvoisin & Associates was formed in 1996 by carving out Inland Imagings administrative team into its own company, it had less than half as many employees as it does today, and just one information-technology specialist, compared with about 50 today.


Pondering the challenges posed by Inland Imagings growth aspirations in Arizona and Nevada, he says, Were so used to being a big entity now that its hard to get back in the startup mode.


In the physician services it provides, Inland Imaging is continuing to see a trend toward subspecialization, such as in interventional radiology, Duvoisin says.


On the information-technology front, its continuing to expand its picture archiving communication (PAC) system, through which it provides health-care providers across the Northwest with electronic access to patient images.


Were starting to have one of the biggest storage capabilities in the area, at about 30 terabytes, Duvoisin says. One terabyte is equivalent to 1,000 gigabytes.


As for equipment, Inland Imaging last year spent about $2.5 million to acquire digital-mammography equipment that Duvoisin says greatly enhanced its imaging capabilities in that area, and it now is evaluating a couple of other pieces of imaging equipment that would have about that same total cost. One is a more advanced MRI machine that is touted to provide images with greater detail and clarity and to offer shorter patient-scan times, but that he says has a narrow set of applications. The other is a next-generation 64-slice CT scanner, used mostly for cardiac imaging, that medical Web sites praise for also offering higher-resolution images and shorter scan times.


Before joining Inland Imaging, Duvoisin was a certified public accountant who had been working for an accounting firm here. He joined the radiology practice after the radiologists who owned it decided they wanted to adopt a more comprehensive business approach.


He shuns attention and downplays his own role in the growth of the enterprise, saying the expansion has been fueled heavily by the introduction and refinement of new imaging technology.


Contact Kim Crompton at (509) 344-1263 or via e-mail at kimc@spokanejournal.com.